| NPI | 1346404415 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MI 4301092881) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35.133999) |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: MI 4301092881) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2023-10-16 |